Knowledge, attitude and practice of prednisolone prevention of chloroquine induced pruritus among Nigerian health workers.

Severe generalized pruritus is a common drawback in chloroquine therapy of malaria in black Africans. In a cross-sectional study, we evaluated the knowledge, attitude and practice of 117 Nigerian hospital workers, who historically itch to chloroquine, to the use of prednisolone to prevent chloroquine pruritus in malaria. Ninety per cent of respondents had a positive family history of chloroquine induced pruritus. Seventy-five per cent (92) of the subjects were aware of the anti-pruritic action of prednisolone, but only 43% (n = 40) have ever used it during malaria. Among the prednisolone users (n = 40), 25 (62.5%) had total prevention, 25% (n = 10) had marked pruritus attenuation, but no effect was seen in 12.5% (n = 5). The modal prednisolone dose causing inhibition of itching was 10 mg orally given once. Concurrent prednisolone increased compliance with chloroquine in 68% of all who used the combination, and there was no evidence of malaria recurrence.